Sex and racial disparities in non-alcoholic fatty liver disease-related cardiovascular events: National inpatient sample analysis (2019)

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases cardiovascular disease(CVD)risk irrespective of other risk factors.However,large-scale cardiovascular sex and race differences are poorly understood.AIM To investigate the relationship between NAFLD and major cardiovascular and cerebrovascular events(MACCE)in subgroups using a nationally representative United States inpatient sample.METHODS We examined National Inpatient Sample(2019)to identify adult hospitalizations with NAFLD by age,sex,and race using ICD-10-CM codes.Clinical and demographic characteristics,comorbidities,and MACCE-related mortality,acute myocardial infarction(AMI),cardiac arrest,and stroke were compared in NAFLD cohorts by sex and race.Multivariable regression analyses were adjusted for sociodemographic characteristics,hospitalization features,and comorbidities.RESULTS We examined 409130 hospitalizations[median 55(IQR 43-66)years]with NFALD.NAFLD was more common in females(1.2%),Hispanics(2%),and Native Americans(1.9%)than whites.Females often reported non-elective admissions,Medicare enrolment,the median age of 55(IQR 42-67),and poor income.Females had higher obesity and uncomplicated diabetes but lower hypertension,hyperlipidemia,and complicated diabetes than males.Hispanics had a median age of 48(IQR 37-60),were Medicaid enrollees,and had non-elective admissions.Hispanics had greater diabetes and obesity rates than whites but lower hypertension and hyperlipidemia.MACCE,all-cause mortality,AMI,cardiac arrest,and stroke were all greater in elderly individuals(P<0.001).MACCE,AMI,and cardiac arrest were more common in men(P<0.001).Native Americans(aOR 1.64)and Asian Pacific Islanders(aOR 1.18)had higher all-cause death risks than whites.CONCLUSION Increasing age and male sex link NAFLD with adverse MACCE outcomes;Native Americans and Asian Pacific Islanders face higher mortality,highlighting a need for tailored interventions and care.

Excess non-COVID-19-related mortality among inflammatory bowel disease decedents during the COVID-19 pandemic

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic disrupted healthcare in the United States.AIM To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death among inflammatory bowel disease(IBD)decedents.METHODS We performed a register-based study using data from the National Vital Statistics System,which reports death data from over 99%of the United States population,from January 1,2006 through December 31,2021.IBD-related deaths among adults 25 years and older were stratified by age,sex,race/ethnicity,place of death,and primary cause of death.Predicted and actual age-standardized mortality rates(ASMRs)per 100000 persons were compared.RESULTS 49782 IBD-related deaths occurred during the study period.Non-COVID-19-related deaths increased by 13.14%in 2020 and 18.12%in 2021[2020 ASMR:1.55 actual vs 1.37 predicted,95%confidence interval(CI):1.26-1.49;2021 ASMR:1.63 actual vs 1.38 predicted,95%CI:1.26-1.49].In 2020,non-COVID-19-related mortality increased by 17.65%in ulcerative colitis(UC)patients between the ages of 25 and 65 and 36.36%in non-Hispanic black(NHB)Crohn’s disease(CD)patients.During the pandemic,deaths at home or on arrival and at medical facilities as well as deaths due to neoplasms also increased.CONCLUSION IBD patients suffered excess non-COVID-19-related death during the pandemic.Excess death was associated with younger age among UC patients,and with NHB race among CD patients.Increased death at home or on arrival and due to neoplasms suggests that delayed presentation and difficulty accessing healthcare may have led to increased IBD mortality.

Does digitalization mitigate regional inequalities?Evidence from China

Regional inequality significantly influences sustainable development and human well-being.In China,there exists pronounced regional disparities in economic and digital advancements;however,scant research delves into the interplay between them.By analyzing the economic development and digitalization gaps at regional and city levels in China,extending the original Cobb-Douglas production function,this study aims to evaluate the impact of digitalization on China's regional inequality using seemingly unrelated regression.The results indicate a greater emphasis on digital inequality compared to economic disparity,with variable coefficients of 0.59 for GDP per capita and 0.92 for the digitalization index over the past four years.However,GDP per capita demonstrates higher spatial concentration than digitalization.Notably,both disparities have shown a gradual reduction in recent years.The southeastern region of the Hu Huanyong Line exhibits superior levels and rates of economic and digital advancement in contrast to the northwestern region.While digitalization propels economic growth,it yields a nuanced impact on achieving balanced regional development,encompassing both positive and negative facets.Our study highlights that the marginal utility of advancing digitalization is more pronounced in less developed regions,but only if the government invests in the digital infrastructure and education in these areas.This study's methodology can be utilized for subsequent research,and our findings hold the potential to the government's regional investment and policy-making.

Comparative analysis of breast and lung cancer survival rates and clinical trial enrollments among rural and urban patients in Georgia

Objectives:Rural patients have poor cancer outcomes and clinical trial(CT)enrollment compared to urban patients due to attitudinal,awareness,and healthcare access differential.Knowledge of cancer survival disparities and CT enrollment is important for designing interventions and innovative approaches to address the stated barriers.The study explores the potential disparities in cancer survival rates and clinical trial enrollments in rural and urban breast and lung cancer patients.Our hypotheses are that for both cancer types,urban cancer patients will have longer 5-year survival rates and higher enrollment rates in clinical trials than those in rural counties.Methods:We compared breast and lung cancer patients’survival rates and enrollment ratios in clinical trials between rural(RUCC 4-9)and urban counties in Georgia at a Comprehensive Cancer Center(CCC).To assess these differences,we carried out a series of independent samples t-tests and Chi-Square tests.Results:The outcomes indicate comparable 5-year survival rates across rural and urban counties for breast and lung cancer patients,failing to substantiate our hypothesis.While clinical trial enrollment rates demonstrated a significant difference between breast and lung cancer patients at CCC,no significant variation was observed based on rural or urban classification.Conclusion:These findings underscore the need for further research into the representation of rural patients with diverse cancer types at CCC and other cancer centers.Further,the findings have considerable implications for the initiation of positive social change to improve CT participation and reduce cancer survival disparities.

A randomized controlled trial of Promoting Physical Activity in Regional and Remote Cancer Survivors(PPARCS)

Background:Physical activity(PA)is important for cancer survivors.Trials of remotely delivered interventions are needed to assist in reaching under-served non-metropolitan cancer survivors.The objective of this study was to ascertain whether wearable technology,coupled with health coaching was effective in increasing PA in breast and colorectal cancer survivors living in regional and remote areas in Australia.Methods:Cancer survivors from 5 states were randomized to intervention and control arms.Intervention participants were given a Fitbit Charge 2TMand received up to 6 telephone health coaching sessions.Control participants received PA print materials.Accelerometer assessments at baseline and 12 weeks measured moderate-to-vigorous PA(MVPA),light PA,and sedentary behavior.Results:Eighty-seven participants were recruited(age=63±11 years;74(85%)female).There was a significant net improvement in MVPA of 49.8 min/week,favoring the intervention group(95%confidence interval(95%CI):13.6-86.1,p=0.007).There was also a net increase in MVPA bouts of 39.5 min/week(95%CI:11.9-67.1,p=0.005),favoring the intervention group.Both groups improved light PA and sedentary behavior,but there were no between-group differences.Conclusion:This’s the first study to demonstrate that,when compared to standard practice(i.e.,PA education),a wearable technology intervention coupled with distance-based health coaching,improves MVPA in non-metropolitan cancer survivors.The results display promise for the use of scalable interventions using smart wearable technology in conjunction with phone-based health coaching to foster increased PA in geographically disadvantaged cancer survivors.

Are there sex-based disparities in cataract surgery?

AIM:To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery.METHODS:This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of Medicine.Data collected included the patient’s health history,ocular comorbidities,operative and post-operative complications,and the post-operative best corrected visual acuity(BCVA).The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the study.RESULTS:A total of 11977 eyes from 7253 patients were included in the study.Ocular comorbidities differed by sex,with males having significantly higher percentages of traumatic cataracts(males 0.7%vs females 0.1%),prior ocular surgery(6.7%vs 5.5%),and mature cataracts(2.8%vs 1.9%).Conversely,females had significantly higher rates of pseudoexfoliation(2.0%vs 3.2%).In unadjusted analysis,males had higher rates of posterior capsular rupture(0.8%vs 0.4%)and vitreous loss(1.0%vs 0.6%),but this difference was not significant after adjustment for confounders.Males had a significantly increased risk of post-operative retinal detachment,but in multivariable analysis this was no longer significant.Males were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy for posterior capsule opacification(OR=0.8,95%CI=0.7-0.9,P=0.0005).The BCVA was slightly worse for males pre-operatively;but post-operatively,both sexes exhibited similar visual acuity of Snellen equivalent 20/25.CONCLUSION:The study finds that in a cohort of patients presenting for cataract surgery,sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for males.However,observed surgical complication rates exhibit almost no difference by sex after adjusting for pre-operative differences and post-operative BCVA is similar between sexes.

Inequality of rural residents'income in China since the targeted poverty alleviation strategy:New trends,causes,and policy implications

Poverty and income inequality are problems faced by many countries including China.Since the implementation of Targeted Poverty Alleviation(TPA),absolute poverty has been eradicated,meanwhile,Chinese rural residents'income and inequality have experienced unprecedented new dynamics,but still,very few studies have focused on them.Hence,we attempt to examine the new trends in Chinese farmers'income inequality and to understand its causes during this period.We observe that China's urban-rural income ratio has been shrinking and the urban-rural inequality has been decreasing from 2014 to 2021.The reduction in the Theil index indicates a decrease in the regional inequality of farmers'income as well,and the decline in inter-regional inequality among eight economic zones contributes about 80%to increased equality.These new trends are caused by the fact that,with the TPA,the incomes of rural residents especially that in destitute areas,grew faster than that of urban residents and farmers in prosperous areas.The higher share of non-agricultural industry and agricultural mechanization level have significant positive impact on regional equality of farmers'income,while urban-rural dual structure has significant negative inhibitory effects.The lowest farmers'income and the highest inequality in the Northwest,and the slowest growth in the Northeast deserve more attention in rural Revitalization.From these findings,we propose four policy implications that would be applied to improve Chinese farmers'income equality,govern relative poverty,and achieve common prosperity in the post-poverty era.

Disparity estimation for multi-scale multi-sensor fusion

The perception module of advanced driver assistance systems plays a vital role.Perception schemes often use a single sensor for data processing and environmental perception or adopt the information processing results of various sensors for the fusion of the detection layer.This paper proposes a multi-scale and multi-sensor data fusion strategy in the front end of perception and accomplishes a multi-sensor function disparity map generation scheme.A binocular stereo vision sensor composed of two cameras and a light deterction and ranging(LiDAR)sensor is used to jointly perceive the environment,and a multi-scale fusion scheme is employed to improve the accuracy of the disparity map.This solution not only has the advantages of dense perception of binocular stereo vision sensors but also considers the perception accuracy of LiDAR sensors.Experiments demonstrate that the multi-scale multi-sensor scheme proposed in this paper significantly improves disparity map estimation.

Overcoming geographical and socioeconomic limitations in colorectal cancer screening

Despite colorectal cancer’s(CRC)high global incidence,residents of low-and middle-income countries,as well as low-income minorities in advanced economies have low screening rates.Observational studies demonstrate that in these groups higher incidence of CRC is observed,yet screening rates remain low for consistent reasons.Low income,low educational background,and lack of awareness in combination with inadequate social security of certain population groups impede access and compliance rates to CRC screening.On the other hand,despite the global availability of multiple screening approaches(colonoscopy,sigmoidoscopy,faecal occult blood test,faecal immunochemical test,computed tomography-colonography,etc.)with proven diagnostic validity,many low-income countries still lack established screening programs.The absence of screening guidelines in these countries along with the heterogeneity of guidelines in the rest of the world,demonstrate the need for global measures to tackle this issue comprehensively.An essential step forward is to develop a global approach that will link specific elements of screening with the incidence and available resources in each country,to ensure the achievement of at least a minimum screening program in low-income countries.Utilizing cheaper,cost-effective techniques,which can be carried out by less specialized healthcare providers,might not be equivalent to endoscopy for CRC screening but seems more realistic for areas with fewer resources.Awareness has been highlighted as the most pivotal element for the effective implementation of any screening program concerning CRC.Moreover,multiple studies have demonstrated that outreach strategies and community-based educational programs are associated with encouraging outcomes,yet a centrally coordinated expansion of these programs could provide more consistent results.Additionally,patient navigator programs,wherever implemented,have increased CRC screening and improved follow-up.Therefore,global coordination and patient education seem to be the main areas on which policy making needs to focus.

Clinical and socioeconomic determinants of survival in biliary tract adenocarcinomas

BACKGROUND Despite advances in detection and treatments,biliary tract cancers continue to have poor survival outcomes.Currently,there is limited data investigating the significance of socioeconomic status,race/ethnicity,and environmental factors in biliary tract cancer survival.Data from the Surveillance,Epidemiology,and End Results database for biliary and gallbladder adenocarcinomas were extracted from 1975 to 2016.Socioe-conomic data included smoking,poverty level,education,adjusted household income,and percentage of foreign-born persons and urban population.Survival was calculated with Cox proportional hazards models for death in the 5-year period following diagnosis.RESULTS Our study included 15883 gallbladder,11466 intrahepatic biliary,12869 extrahepatic biliary and 7268 ampulla of Vater adenocarcinoma cases.When analyzing county-specific demographics,patients from counties with higher incomes were associated with higher survival rates[hazard ratio(HR)=0.97,P<0.05].Similarly,counties with a higher percentage of patients with a college level education and counties with a higher urban population had higher 5-year survival rates(HR=0.96,P=0.002 and HR=0.97,P=0.004,respectively).CONCLUSION Worse survival outcomes were observed in lower income counties while higher income and education level were associated with higher 5-year overall survival among gallbladder and biliary malignancies.

Prostate cancer temporal and regional trends in Brazil

Objectives:The Brazilian Unified Health System(SistemaÚnico de Saúde−SUS)is the universal public healthcare system of Brazil that maintains a nationwide database of its patients.Our primary objective was to analyze regional and temporal trends,while our secondary goal was to establish correlations between states’health economy status and their prostate cancer(PCa)epidemiology.Methods:We analyzed Brazil’s nationwide data on prostate cancer(PCa)incidence,mortality,and care gathered between 2013 and 2021 by the Information Technology Department of SUS(DATA-SUS),updated monthly using the International Classification of Diseases(ICD-10)code.Results:In the period,273,933 new cases of PCa and 135,336 PCa deaths were reported in men aged 50 years or over in Brazil.The median annual PCa-specific incidence rate(PCSIR)ranged from 14.7 in the Southeast to 6.9 in the North region and the median annual PCa-specific mortality rate(PCSMR)ranged from 7.7 in the Northeast to 6.0 in the South region(per 10,000 men>50).The median annual mortality to incidence ratio(MIR)was highest in the North(0.88)and lowest in the Southeast region(0.44).There were significant regional differences in PCa treatment rates(per new cases);the Midwest region had the highest median annual surgery rate(0.63)while the North region had the highest median annual systemic therapy rate(0.75)and the lowest radiation therapy rate(0.06).Temporal analysis of the data showed significant change in annual rate trends after the year 2018 for PCSIR(coefficient[β]=+3.66,p<0.001),any treatment(β=−0.06,p=0.016),surgery([SR]β=+0.05,p=0.017)radiation therapy([RTR]β=−0.06,p=0.005)and systemic therapy([STR]β=−0.10,p=0.002).After the 2020 pandemic,annual PCSIR decreased(β=−2.15,p=0.002)but annual PCSMR,MIR,and treatment rates remained stable.Correlation studies showed that the PCSIR was strongly negatively correlated with STR(p<0.001)and positively correlated with RTR(p=0.004).MIR was positively correlated with STR(p<0.001)and negatively correlated with the number of robotic surgical systems per million population(p=0.003).Conclusion:Our data shows that PCa care is dependent on the region and is likely influenced by access to treatment options.Furthermore,changes after the year 2018 underscore the influence of international guidelines on Brazilian clinicians’decision-making especially concerning population screening which in turn affected incidence and treatment rates.Limitation of our study includes limited patientrelated information and data on private practices as well as an unknown impact of traveling patients.

Disparities in the impact of economic well-being on self-esteem in adulthood:Race and ethnicity

BACKGROUND Most studies have defined economic well-being as socioeconomic status,with little attention given to whether other indicators influence self-esteem.Little is known about racial/ethnic disparities in the relationship between economic wellbeing and self-esteem during adulthood.AIM To explore the impact of economic well-being on self-esteem in adulthood and differences in the association across race/ethnicity.METHODS The current study used data from the National Longitudinal Survey of Youth 1979.The final sample consisted of 2267 African Americans,1425 Hispanics,and 3678 non-Hispanic Whites.Ordinary linear regression analyses and logistic regression analyses were conducted.RESULTS African Americans and Hispanics were more likely to be in poverty in comparison with non-Hispanic Whites.More African Americans were unemployed than Whites.Those who received fringe benefits,were more satisfied with jobs,and were employed were more likely to have higher levels of self-esteem.Poverty was negatively associated with self-esteem.Interaction effects were found between African Americans and job satisfaction predicting self-esteem.CONCLUSION The role of employers is important in cultivating employees’self-esteem.Satisfactory outcomes or feelings of happiness from the workplace may be more important to non-Hispanic Whites compared to African Americans and Hispanics.

Bridging the gap: Addressing disparities in hepatitis C screening, access to care, and treatment outcomes

Hepatitis C virus(HCV)is a significant public health challenge globally,with substantial morbidity and mortality due to chronic liver disease.Despite the availability of highly effective and well-tolerated direct-acting antiviral therapies,widespread disparities remain in hepatitis C screening,access to treatment,linkage to care,and therapeutic outcomes.This review article synthesizes evi-dence from various studies to highlight the multifactorial nature of these dispari-ties,which affects ethnic minorities,people with lower socioeconomic status,in-dividuals with substance use disorders,and those within correctional facilities.The review also discusses policy implications and targeted strategies needed to overcome barriers and ensure equitable care for all individuals with HCV.Recom-mendations for future research to address gaps in knowledge and evaluation of the effectiveness of interventions designed to reduce disparities are provided.

Characteristics and distinct prognostic determinants of individuals with hepatosplenic T-cell lymphoma over the past two decades

BACKGROUND Hepatosplenic T-cell lymphoma(HSTCL)is a rare and aggressive peripheral T-cell lymphoma with historically dismal outcomes,representing less than one percent of non-Hodgkin lymphomas.Given its rarity,the true incidence of HSTCL is unknown and most data have been extrapolated through case reports.To the best of our knowledge,the largest and most up to date study addressing the epidemiology and outcomes of patients with HSTCL in the United States covered a period from 1996 to 2014,with a sample size of 122 patients.AIM To paint the most updated epidemiological picture of HSTCL.METHODS A total of 186 patients diagnosed with HSTCL,between 2000 and 2017,were ultimately enrolled in our study by retrieving data from the Surveillance,Epidemiology,and End Results database.We analyzed demographics,clinical characteristics,and overall mortality(OM)as well as cancer-specific mortality(CSM)of HSTCL.Variables with a P value<0.01 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors,with a hazard ratio of greater than 1 representing adverse prog-nostic factors.CONCLUSION Overall,the outlook for this rare malignancy is very grim.In this retrospective cohort study of the United States population,non-Hispanic blacks and the elderly had a higher CSM.This data highlights the need for larger prospective studies to investigate factors associated with worse prognosis in one ethnic group,such as treatment delays,which have been shown to increase mortality in this racial/ethnic group for other cancers.

Prevalence and resistance of Helicobacter pylori in a predominantly Hispanic population

BACKGROUND Helicobacter pylori(H.pylori)is the most common chronic bacterial infection in humans.The risk of acquiring H.pylori is related to socioeconomic status and living conditions early in life.Treatment regimens must consider local antibiotic resistance patterns.Adventist Health White Memorial Hospital serves a predominantly indigent population in east Los Angeles with a large number of immigrants from South and Central America.Data regarding the prevalence and resistance of H.pylori in this population is scant.AIM To evaluate the prevalence and resistance of H.pylori and correlate with country of origin.METHODS All gastric biopsies were obtained by a single gastroenterologist at the hospital in a consecutive manner from patients with gastritis from 2017 to 2022 and sent to various labs for evaluation.RESULTS Two hundred and sixty-six patients are born in the United States,450,171,70,and 30 patients are immigrants from Mexico,Central and South America(CSA),Asia,and other countries respectively.Overall,14.65%were found to be infected with H.pylori.Rates of infection in United States-born citizens,immigrants from Mexico,CSA,and Asia are 9.02%,18.67%,13.45%,and 11.43%respectively,with Mexican immigrants having a relative risk of 2.3889[95%confidence interval(CI):1.4789-3.8588,P=0.0004]compared to those born in United States.No correlation seen between infection and length of time immigrants were in United States.Relative risk of infection in patients with no proton pump inhibitor use within the past 30 days found to be 1.9276(95%CI:1.3562-2.7398,P=0.0003).Rates of resistance for clarithromycin and levofloxacin are 21.43%and 31.11%.CONCLUSION H.pylori infection appears to be associated with low socioeconomic status and poor living conditions early in life.Clarithromycin and levofloxacin based treatment regimens should be avoided as first line therapy in this region,particularly in patients of Latin American origin.

Assessing the Spatial Equality of COVID Testing Sites Maintaining Zero COVID Policy

Rapid and timely testing is essential to minimize the COVID-19 spread. Decision makers and policy planners need to determine the equal distribution and accessibility of testing sites. This study mainly examines the spatial equality of COVID-19 testing sites that maintain a zero COVID policy in Guangzhou City. The study has identified the spatial disparities of COVID testing sites, characteristics of testing locations, and accessibility. The study has obtained information on COVID testing sites in Guangzhou City and population data. Point pattern analyses, Euclidian distance and allocation, and network analyses are the main methods used to achieve the research objectives, and 1183 total COVID testing sites can be recognized in Guangzhou City. Results revealed that spatial disparities could be noticed over the study area. Testing locations of Guangzhou City are highly clustered. The most significant testing sites are located in Haizhu District, which has the third largest population. The highest population density can be identified in Yuexiu District. However, only 94 testing sites are located there. According to all the results, higher disparities can be identified, and a lack of testing sites is located in the north part of the study area. Some people in the northern part have to travel more than 10 km to reach a testing site. Finally, this paper suggests increasing the number of testing sites in the north and south parts of the study area and keeping the same distribution, considering the area, total population, and population density. This kind of research will be helpful to decision-makers in making proper decisions to maintain a zero COVID policy.

Gastric Cancer Disparities in the United States: Overcoming the Barriers

In this narrative review, we highlight the disparities in the incidence and mortality of gastric cancer across various racial and ethnic populations in the United States (US). Despite the low and decreasing trend in the incidence of gastric cancer in the US, the incidence remains significantly high among Asian and Hispanic Americans, showing a striking racial and ethnic disparity. The low survival rate of gastric cancer further accentuates the magnitude of this disparity. In addition, there is a marked funding disparity among different cancers in the US, reflecting the significantly lower level of support for cancers, such as gastric cancer, which are more prevalent in minority populations, compared to the cancers more prevalent among non-Hispanic Whites (NHW). Moreover, the economic burden from health disparities remains high. Although studies from the US and Asia suggest that screening for stomach cancer may be cost-effective, there is no currently available guideline for scree-ning high-risk populations in the US. A multidimensional framework involving the community, physicians, and policymakers is proposed to tackle these gastric cancer disparities and to develop population-based screening and surveillance programs to reduce the burden of gastric cancer.

Chronic Hepatitis B in Indian Americans: Lack of Screening and Poor Linkage to Care

Background: Chronic hepatitis B (CHB) is a major cause of liver-related morbidity and mortality in the United States (US) and globally. CHB disproportionately affects Asian Americans and many other immigrant minority populations, primarily owing to the high prevalence of CHB in their countries of origin. India is a country with a medium-to-high prevalence of hepatitis B (HB) (>2%) and has over 40 million people infected with hepatitis B virus (HBV), with more than 115,000 deaths annually from HBV-related complications. Indian Americans are one of the largest immigrant populations in the US but remain underdiagnosed and poorly linked to clinical care. We, therefore, assessed the HBV prevalence and evaluated the linkage-to-care (LTC) among Indian Americans to develop strategic plans to reduce the impact of HBV in the US. Methods: Between April 2022 and January 2024, serologic screening and surveys were provided to 328 Indian American adults (age 20 - 80) in New York City. All participants were tested for a triple panel consisting of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core IgG antibody (anti-HBc). A survey was conducted on the subjects chronically infected with HBV regarding their histories of infection. Self-administered questionnaires were employed to evaluate demographic and epidemiologic characteristics. Results: Of 328 screened and evaluated (246 males and 82 females), 10 (3.0%) were HBV-infected, 222 (67.7%) were susceptible to HBV, and 96 (29.3%) were immune. The prevalence of chronic HBV varied between the age groups: 4.6% (age 20 - 40), 3.4% (age 41 - 60), and 1.7% (age 61 - 80). Of 10 chronically infected, only two subjects had been previously diagnosed but were not engaged in care. Conclusion: HBV disproportionately affects Asian Americans, primarily owing to immigration from parts of the world where the disease is endemic. Indian Americans belong to an intermediate-risk group, with an HBV prevalence of >2%, but remain underdiagnosed and poorly linked to care. Our pilot study on Indian American populations, the first of its kind, demonstrates a 3% prevalence of CHB, none of whom are linked to care. In addition, this population has a high percentage of unimmune subjects, creating a large reservoir for future infection. With the growing population of Indian Americans, our findings can be used to develop community-based strategies for HBV screenings and LTC that target high-risk groups.

Geographical Accessibility to Basic Infrastructures and Services in Rural Senegal: The Case of the Niakhar Area

Access to basic infrastructure and services is a factor in economic development and an important aspect in combatting social and spatial disparities. But this access is often subject to several constraints, including geographical accessibility. In this article, we aim to analyze the geographical accessibility to basic infrastructure and services in the Niakhar area, using the improved two step floating catchment area method and local spatial association indicators. The results reveal that the areas with high accessibility to health and education infrastructures and services are mainly located along the south-east and north-west gradient, while those with low accessibility are found in the south-west and north-east center. They also show high accessibility to trade services in the center of the study area.

How Does E-Commerce Policy Affect Consumption Disparities of Rural Households?-Evidence from China

In the context of China’s ongoing efforts to promote countryside revitalization and facilitate domestic economic circulation,it is of great significance to reduce the consumption disparity among rural households and unleash the consumption potential in the countryside.Based on data from China Family Panel Studies,this paper adopts a staggered difference-in-differences method to assess the impact of the e-commerce to enter rural areas on the consumption disparity among rural households.Findings:the comprehensive demonstration work of promoting e-commerce to enter rural areas has reduced the consumption disparity among rural households through the following mechanisms.Firstly,this policy initiative has mitigated the consumption-inhibiting effect on rural household consumption due to the local market size and external market accessibility by promoting the distribution of consumer goods to villages.Secondly,this policy initiative has also increased the agricultural income of rural households and reduced their consumption disparity by distributing farm produce to cities and enhancing the agricultural income of rural households.Moreover,the work is characterized by inclusive growth and is not susceptible to the“elite capture”phenomenon.